Hormonal
In obese adults, excess visceral fat and insulin resistance are independently associated with incident prediabetes and type 2 diabetes, whereas general adiposity markers (BMI, total body fat, abdominal subcutaneous fat) are not.
If you are obese, your total weight or BMI is not the best predictor of your diabetes risk. Instead, focus on markers of 'dysfunctional adiposity': visceral fat (belly fat), insulin resistance, and liver fat. These specific factors drive the transition to prediabetes and diabetes, whereas general fat mass does not. Monitoring visceral fat and insulin sensitivity is more clinically relevant than tracking BMI alone.
Excess visceral fat and insulin resistance, but not general adiposity, were independently associated with incident prediabetes and type 2 diabetes mellitus in obese adults.
Why this rating
Multi-ethnic, population-based cohort with longitudinal follow-up (median 7 years) and rigorous imaging (MRI/DEXA), though observational.
Source
Dysfunctional Adiposity and the Risk of Prediabetes and Type 2 Diabetes in Obese Adults
Ian J. Neeland et al. · JAMA · 2012
DOI 10.1001/2012.jama.11132
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